Effectiveness of Dental Caries Arrest Treatment in Primary Teeth Using AgNO3 Followed by NaF Varnish

NCT02019160 | Completed Phase 3

• 1 other identifier: chuch14
• Study Type: interventional
• Target: 1,070
• Locations: 1 country
• Sites: 1

Brief Summary

• Aim: This randomised controlled trial will systematically compare the efficacy of a 25% AgNO3 solution followed by 5% NaF varnish with that of a 38% SDF solution in arresting caries teeth among preschool children when applied at half-yearly intervals over a 30-month period.
• Method: The extension of the Consolidated Standards of Reporting Trials 2010 Statement will be followed for this 30-month, randomised, double-blinded, non-inferiority clinical trial. Approximately 2,400 kindergarten children will be screened and at least 826 children with caries will be recruited. This sample size is sufficient for an appropriate statistical analysis (power at 90% \[β=0.10\] with a 2-sided type-I error of α=0.05), allowing for a 18% drop-out rate. The children will be randomly allocated into 2 groups to treat their caries over a 30-month period: Group A - biannual application of a 25% AgNO3 solution followed by a 5% NaF varnish, and Group B - biannual application of a 38% SDF solution followed by a placebo varnish.Clinical examinations will be conducted at 6-month intervals to assess whether the caries are arrested. Information on confounding factors such as oral hygiene habits will be collected through a parental questionnaire.
• Possible results and implications: As the first of its kind, this study would help to determine whether AgNO3 followed by NaF is at least as effective as SDF in arresting childhood caries. If so, because 25% AgNO3 and 5% NaF contain less silver and fluoride, respectively, than 38% SDF, their use would be more favourable than SDF in young children.

Conditions

Early Childhood Caries

Keywords

silver nitrate; sodium fluoride; silver diamine fluoride; caries; non-inferiority trial

Outcome Measures

Primary Outcomes (1)

• The hardness of cavity on tooth by probing

  We expect that topical application of 25% AgNO3 solution followed by 5% NaF varnish and of 38% SDF solution can both effectively arrest ECC.

  The follow-up oral examinations will be conducted every 6 months for 30 months totally

Study Arms (2)

Silver nitrate

EXPERIMENTAL

Biannual application of 25% AgNO3 solution followed by 5% NaF varnish.

Drug: 25% AgNO3 solution followed by 5% NaF varnish

Silver diamine fluoride

ACTIVE COMPARATOR

Biannual application of 38% SDF solution followed by placebo varnish.

Drug: 38% SDF solution followed by placebo varnish

Interventions

25% AgNO3 solution followed by 5% NaF varnish DRUG

Dosage of 4.4μg±1.4μg fluoride per use

Also known as: silver nitrate, sodium fluoride

Silver nitrate

38% SDF solution followed by placebo varnish DRUG

Dosage of 8.8μg±2.8μg fluoride per use

Also known as: silver diamine fluoride

Silver diamine fluoride

Eligibility Criteria

• Age: 3 Years - 5 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Kindergarteners who have joined our outreach dental service will be invited to join this study. Preschool children aged 3-4 years who have tooth decay and are attending the first year of kindergarten will be invited to join this study.

You may not qualify if:

• Children who are uncooperative and difficult to manage, have major systemic diseases, or are on long-term medication will be excluded.

Sponsors & Collaborators

• The University of Hong Kong: lead

Study Sites (1)

The University of Hong Kong

Hong Kong, China

Location

Related Publications (7)

• Braga MM, Mendes FM, De Benedetto MS, Imparato JC. Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. J Dent Child (Chic). 2009 Jan-Apr;76(1):28-33.

  PMID: 19341576 BACKGROUND

• Chu CH, Fung DS, Lo EC. Dental caries status of preschool children in Hong Kong. Br Dent J. 1999 Dec 11;187(11):616-20; discussion 605. doi: 10.1038/sj.bdj.4800347.

  PMID: 16163284 BACKGROUND

• Chu CH. Treatment of early childhood caries: a review and case report. Gen Dent. 2000 Mar-Apr;48(2):142-8.

  PMID: 11199573 BACKGROUND

• Chu CH, Lo EC, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res. 2002 Nov;81(11):767-70. doi: 10.1177/0810767.

  PMID: 12407092 BACKGROUND

• Chu CH, Lo EC. A review of sodium fluoride varnish. Gen Dent. 2006 Jul-Aug;54(4):247-53.

  PMID: 16903196 BACKGROUND

• Gao SS, Duangthip D, Wong MCM, Lo ECM, Chu CH. Randomized Trial of Silver Nitrate with Sodium Fluoride for Caries Arrest. JDR Clin Trans Res. 2019 Apr;4(2):126-134. doi: 10.1177/2380084418818482. Epub 2019 Feb 15.

  PMID: 30931709 DERIVED

• Chu CH, Gao SS, Li SK, Wong MC, Lo EC. The effectiveness of the biannual application of silver nitrate solution followed by sodium fluoride varnish in arresting early childhood caries in preschool children: study protocol for a randomised controlled trial. Trials. 2015 Sep 25;16:426. doi: 10.1186/s13063-015-0960-2.

  PMID: 26407698 DERIVED

MeSH Terms

Interventions

Silver Nitrate; Sodium Fluoride; silver diamine fluoride

Intervention Hierarchy (Ancestors)

Nitrates; Nitric Acid; Nitrogen Compounds; Inorganic Chemicals; Silver Compounds; Fluorides; Hydrofluoric Acid; Fluorine Compounds; Sodium Compounds; Cariostatic Agents; Biomedical and Dental Materials; Manufactured Materials; Technology, Industry, and Agriculture

Study Officials

• Chun Hung Chu

  The University of Hong Kong

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: December 11, 2013
• First Posted: December 24, 2013
• Study Start: September 1, 2014
• Primary Completion: June 1, 2018
• Study Completion: June 1, 2018
• Last Updated: September 26, 2019

Record last verified: 2019-09

Locations

CN (1)